Exam 7

Exam 7 THIS EXAM CONTAINS 80 QUESTIONS - MUST RETAKE UNTIL YOU MISS 12 OR LESS. Some answers may be keyed wrong. Please bring this to our attention to change.

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Hypothermia occurs when:

A.	heat gained exceeds heat lost.

B.	heat lost exceeds heat gained.

C.	air temperature exceeds body temperature.

D.	air temperature drops below body temperature.

Hyperthermia occurs when:

A.	heat gained exceeds heat lost.

B.	heat lost exceeds heat gained.

C.	air temperature exceeds body temperature.

D.	air temperature drops below body temperature.

What is the process by which a person loses body heat to cooler ambient air?

A.	radiation.

B.	constriction.

C.	conduction.

D.	evaporation.

What is the process by which a person loses body heat to a cooler area by air moving across the body surface?

A.	radiation.

B.	convection.

C.	conduction.

D.	evaporation.

What is the process by which a person loses body heat when touching a cold object?

A.	radiation.

B.	convection.

C.	conduction.

D.	evaporation.

What is the process by which a person loses body heat by sweating?

A.	radiation.

B.	convection.

C.	conduction.

D.	evaporation.

In a hypothermic patient, pulses should be checked for how many seconds before starting CPR?

10.

20.

30.

60.

Where should you place the back of your hand when checking for skin temperature on a patient experiencing a cold emergency?

neck.

hand.

forehead.

abdomen.

10.

Which of the following is NOT a factor leading to hypothermia?

drugs.

B.	excessive clothing.

C.	cold environment.

D.	injuries to the spinal cord.

11.

Which of the following should NOT be used in rewarming a moderately or severely hypothermic patient?

blankets

B.	hot coffee or tea

C.	the ambulance compartment heaters

D.	heat packs to the groin, axillary, and cervical regions

12.

Which of the following steps should NOT be taken in treating a patient with deep localized cold injuries?

A.	Remove all jewelry.

B.	Leave all blisters intact.

C.	Rewarm the area by applying heat.

D.	Cover the area with dry, sterile dressings.

13.

Which of the following is NOT a late sign of a deep localized cold injury?

A.	The skin remains soft.

B.	The skin is white and waxy.

C.	Blisters are present.

D.	Swelling is present.

14.

In a wilderness situation or when an extremely long or delayed transport is inevitable, you should treat a deep localized cold injury by:

A.	re-exposing the part to the cold.

B.	rubbing the affected part with alcohol.

C.	immersing the affected part in an ice-water bath.

D.	immersing the affected part in a warm-water bath (at least 105 degrees).

16.

When a person has a superficial cold injury, rubbing or massaging the area will cause:

A.	irreversible shock.

B.	an increase in cellular metabolism.

C.	an increase in carbon dioxide production.

D.	further damage to the tissues.

17.

High humidity reduces the body's ability to lose heat through:

A.	radiation.

B.	convection.

C.	conduction.

D.	evaporation.

20.

A true heat exposure emergency exists if the skin is:

A.	blanching and dry.

B.	hot to the touch and dry.

C.	mottling, tingling, and dry.

D.	normal temperature and moist.

21.

Your care for a patient with moist, pale skin and normal to cool skin temperature in the context of a hot environment should include:

A.	keeping the skin wet with alcohol.

B.	massaging the body to increase blood flow.

C.	applying cold packs to the neck, groin, and armpits.

D.	having the patient drink water if the patient is responsive and not vomiting.

22.

Your care for a patient with hot, dry skin should include:

A.	putting the patient in a sitting position.

B.	massaging the body to increase blood flow.

C.	cooling the patient rapidly to cause shivering.

D.	applying cold packs to the neck, groin, and armpits.

23.

Any drowning of unknown origin should be treated as a(n):

stroke.

B.	air embolism.

C.	possible spinal injury.

D.	cold water immersion.

24.

The most likely mechanism of injury responsible for a scuba diving ascent injury is:

A.	cold water.

B.	alcohol consumption.

C.	a decrease in atmospheric pressure.

D.	too rapid of an ascent.

25.

A patient who has been involved in a scuba diving emergency should be transported in what position?

A.	left side with the head lower than the feet.

B.	left side with the head higher than the feet.

C.	right side with the head lower than the feet.

D.	right side with the head higher than the feet.

28.

On a hot summer afternoon, you are dispatched to a railroad for several "men down." You are on the first arriving unit and determine that several men who were locked in a boxcar have died. The one surviving man in his 20s is unconscious; he has hot, dry skin and feels extremely warm to touch. There is no sign of trauma. After securing the patient's airway, you should:

A.	avoid moving him, since this is a crime scene.

B.	attempt to have him drink at least 1 quart of cold water.

C.	remove his clothing and place wet towels on him to help cool the skin.

D.	turn the heaters on to maintain a neutral environment for the patient.

29.

It is important to keep patients well wrapped in winter, as they may lose body heat by lying on a cold surface. This type of heat loss is known as:

A.	conduction.

B.	convection.

C.	radiation.

D.	evaporation.

30.

Proper care of a patient with hypothermia should include:

A.	removing the patient from the cold environment.

B.	rewarming the patient in the field with hot packs.

C.	giving oxygen from a tank packed in snow.

D.	withholding CPR if cardiac arrest is believed to have lasted for over 25 minutes.

31.

You are dispatched to a diving accident at a deep reservoir. Upon arrival, a woman identifying herself as a diving instructor informs you that she was conducting a class at about 50 feet when one of her students suddenly panicked and made a rapid ascent. She tells you that the student did not release air from his buoyancy control device and "popped" out of the water when he hit the surface. The patient is having difficulty breathing, complaining of dizziness, and is vomiting. You should first:

A.	place him on his left side with his head down.

B.	listen for chest sounds.

C.	give oxygen.

D.	determine how long he was at the depth of 50 feet.

33.

For most cases of heat exhaustion, when fluid is given, the fluid of choice is:

A.	plain water.

B.	fruit juices.

C.	balanced electrolyte drinks.

D.	mild salt water.

34.

You are caring for a 44-year-old female who has been drinking beer all day at an outdoor summer concert. Your focused history and exam reveal hot, dry skin; a weak, rapid pulse; and a decreased level of consciousness. Care of this patient includes:

A.	covering her with a single dry sheet.

B.	giving her a weak electrolyte drink.

C.	administering oxygen with a nonrebreathing mask.

D.	rapid cooling of the patient until she starts to shiver.

37.

Which of the following drugs can produce disruptive behavior?

aspirin.

alcohol.

C.	tetracycline.

D.	activated charcoal.

38.

Your patient is lying supine. He is incoherent and sluggish, and his breath smells of alcohol. The police identify him as a chronic alcoholic. What other condition could cause this patient's change in behavior?

gout.

bursitis.

C.	mild hypertension.

D.	uncontrolled diabetes.

40.

A patient who is considering committing suicide might:

A.	watch the news.

B.	clean the house.

C.	make vacation plans.

D.	A patient who is considering committing suicide might:

41.

You are treating an unwilling patient who needs emergency medical care for a severe mental disturbance. To make sure that the patient's rights are not violated, you should get help from:

a nurse.

a lawyer.

C.	the police.

D.	medical control.

42.

You have been called to a scene where the patient is displaying violent behavior. You should begin your assessment:

A.	as you approach the scene.

B.	after the arrival of the police.

C.	after talking to family members.

D.	after receiving consent from the patient.

43.

How many people are needed to safely restrain a patient?

46.

The most effective way to manage disruptive patients is to:

A.	confront them and take charge.

B.	ask questions timidly.

C.	be direct.

D.	delay medical treatment until they cooperate.

47.

When assessing a patient who has attempted suicide, you should:

A.	not be concerned about another attempt if the patient was the one who called for help.

B.	be able to tell the difference between a "gesture" and a serious attempt.

C.	recognize that multiple wrist slashes will not produce significant injury.

D.	never leave the patient alone.

48.

Which of the following organs provides nourishment to and removes waste products from the baby?

cervix.

vagina.

placenta.

perineum.

49.

You have delivered an infant who is not breathing. After suctioning and physical stimulation, there are no respirations. You should:

A.	administer free-flow oxygen.

B.	clamp and cut the umbilical cord.

C.	provide BMV or Mouth to Mask ventilations at a rate of 40 to 60/min.

D.	start chest compressions at a rate of 60/min.

50.

After birth, you notice that the infant's face and trunk appear blue. This is called:

A.	pallor cyanosis.

B.	central cyanosis.

C.	peripheral cyanosis.

D.	circumoral cyanosis.

51.

You are rapidly transporting a patient who is at full term and presenting with a prolapsed cord. This patient is best placed:

A.	on her left side.

B.	in the prone position.

C.	head up with her feet down.

D.	in Trendelenburg's position.

52.

While examining a patient who is in active labor, you see the umbilical cord outside the vagina, ahead of the infant's head. What should you do first?

A.	Hold the mother's legs together and rapidly transport.

B.	Push the infant's head with a sterile gloved hand to relieve pressure on the cord until delivery.

C.	Gently replace as much of the cord as possible, and apply a moist dressing over the vagina.

D.	Apply gentle pressure to the head with a sterile gloved hand to prevent an explosive delivery of the cord.

53.

You arrive at the scene where the mother has already delivered her baby. Your partner is caring for the infant. You note a large blood loss from the mother, and she appears to still be bleeding. You should:

A.	massage the uterus firmly with a circular motion.

B.	prepare the mother for transport since 1,000 mL of blood loss is normal following delivery.

C.	instruct the mother to lie with her knees drawn up and elevate her buttocks to control the bleeding.

D.	let the mother go to the bathroom and then apply vaginal pads around the vagina to soak up the remaining blood.

54.

You are preparing a mother and her newborn infant for transport when the placenta begins to deliver. What should you do to deliver the placenta?

A.	Firmly grasp the umbilical cord and pull the placenta from the mother to help reduce her pain.

B.	Place a sterile gloved hand inside the vagina to slightly elevate the placenta and to reduce pressure on the cord.

C.	Help the mother hold her legs together to delay placenta delivery until you arrive at the hospital.

D.	Help the mother with delivery of the placenta. Bring the placenta with you to the hospital in a plastic bag.

55.

Your patient is in active labor. You note that the infant's foot is presenting through the vagina. You should immediately:

A.	elevate the patient's pelvis and rapidly transport while giving the patient oxygen.

B.	locate and massage the uterus by kneading it with your fingers fully extended.

C.	prepare the patient for delivery, as this is a reliable sign that delivery is coming soon.

D.	insert a sterile gloved hand into the vagina to relieve pressure on the umbilical cord.

56.

Why is delivery with a prolapsed cord considered a true emergency?

A.	It is a sign that the baby is too large to be delivered outside of the hospital.

B.	It is a sign of a possible miscarriage as the baby's blood supply is cut off.

C.	It might threaten the baby's life because the baby's blood supply is cut off.

D.	It might threaten the mother's life, as the decrease in blood supply might lead to seizures.

57.

Your patient is an obviously pregnant woman complaining of abdominal pain and vaginal bleeding. Her husband says that her pain has been constant for the past 30 minutes, and there is blood all over the bed. Your exam shows that she does not appear to be crowning, and she is still bleeding from the vagina. What should you do next?

A.	You should prepare for delivery because this is a predelivery emergency placenta previa.

B.	You should massage the uterus to control the bleeding, apply oxygen, and transport the patient on her left side.

C.	You should apply oxygen and prepare the patient for delivery because delivery is coming soon.

D.	You should apply oxygen and rapidly transport because there is a possible life-threatening problem with the placenta.

58.

As the baby's head delivers, you notice that the amniotic sac is still intact and is covering the baby's head. What should you do?

A.	Prepare the mother for rapid transport, as this is a true emergency.

B.	Break open the sac, and remove the tissue from the baby's mouth and nose.

C.	Prepare for delivery of the baby's body by supporting the head with both hands.

D.	Tell the mother to push to speed up the delivery so that you can remove the tissue from the baby's mouth and nose.

59.

With placenta previa:

A.	the mother is at a high risk for seizures.

B.	the placenta does not deliver, and the mother is at a high risk for shock.

C.	the placenta is located high in the uterus, the baby is at risk for a fast delivery, and the mother is at risk for shock.

D.	the placenta is abnormally located in the uterus. It interferes with delivery of the baby and puts the mother at risk for shock.

60.

How do placenta previa and abruptio placenta differ?

A.	Abruptio placenta occurs in early pregnancy. Placenta previa occurs in late pregnancy.

B.	Abruptio placenta is a reliable sign that the infant is at high risk for an explosive delivery. Placenta previa signals a slow, painful delivery.

C.	Placenta previa is associated with severe abdominal pain. Abruptio placenta is associated with severe headaches.

D.	Placenta previa occurs when the placenta is covering the cervix. Abruptio placenta occurs when the placenta separates before delivery of the infant, no matter where it is located.

62.

After delivering a baby, you should dry the baby completely. What should you do next?

A.	Wrap the baby in warm blankets.

B.	Wrap the baby in sterile saline sheets.

C.	Cool the baby to stimulate crying.

D.	Cut the umbilical cord.

63.

A mother who is about to deliver tells you that she is expecting twins. You should be prepared for the possibility that:

A.	both newborns will deliver quickly.

B.	they might be so small as to look premature.

C.	multiple births usually induce seizures in the mother.

D.	multiple births are associated with explosive deliveries.

65.

You have suctioned, dried, and wrapped the newborn in a blanket. The baby is still not breathing. You should stimulate the baby by:

A.	cooling it off with saline-soaked sheets.

B.	clamping and cutting the umbilical cord.

C.	flicking the soles of the feet and rubbing its back.

D.	holding it with its head slightly higher than its body.

66.

What is considered a breech birth?

A.	The baby is born prematurely.

B.	The baby's face is the presenting part.

C.	The baby's head is too large to be delivered.

D.	The baby's buttocks are the presenting part.

67.

Which of the following, combined with a breech birth, puts the delivery of a newborn at a higher risk?

A.	prolapsed cord.

B.	face presentation.

C.	short umbilical cord.

D.	rapid labor and delivery.

68.

The newborn should be placed in which position until the umbilical cord is cut?

A.	in the father's arms

B.	elevated on a pillow.

C.	at the level of the vagina.

D.	on the mother's stomach.

71.

A mother is delivering in her home. The baby's head is crowning. You should:

A.	dry the newborn's head with a sterile dressing.

B.	administer free-flow oxygen to the newborn at 10 to 15 liters per minute.

C.	apply gentle pressure to the head with your fingers to prevent an explosive delivery.

D.	apply gentle pressure to the mother's abdomen to assist with delivery of the body.

72.

Which of the following situations would indicate adequate breathing when you assess a newborn's breathing?

A.	a delivery time of less than 1 hour.

B.	a breathing rate of 20/min.

C.	a newborn with a strong cry.

D.	a newborn with peripheral cyanosis.

74.

Factors that help you to assess whether a delivery is to take place soon include frequency and length of contractions, crowning, and the:

A.	baby's due date.

B.	mother's complaints of nausea.

C.	mother's complaints of increased pressure in her rectum.

D.	mother's complaints of increasing pain with each contraction.

76.

Pregnant patients who are not in labor should be transported on the left side to avoid:

A.	pressure on the uterus that could cause placenta previa.

B.	pressure on the uterus that could cause the fetus to have a bowel movement.

C.	increasing the mother's blood pressure by compressing the inferior vena cava.

D.	decreasing the mother's blood pressure by compressing the inferior vena cava.

77.

In a multiple birth delivery, you should:

A.	plan for placenta previa.

B.	clamp and cut the umbilical cord after the first birth.

C.	plan on at least one of the fetuses being a breech delivery.

D.	begin transport if the second fetus has not delivered within 5 minutes of the first.

78.

Clamping and cutting the umbilical cord should be completed:

A.	by a doctor at the hospital.

B.	after the baby is born.

C.	by you after delivery of the placenta.

D.	as soon as the cord is visible.

79.

How can you assist the mother in stimulating her uterus to contract to deliver the placenta?

A.	Elevate her legs 6 to 8 inches.

B.	Allow her to nurse the newborn.

C.	Give her a glass of water to drink.

D.	Apply gentle pressure to the perineum.

80.

When the placenta separates early from the uterine lining, it is called:

A.	endometriosis.

B.	placenta previa.

C.	abruptio placenta.

D.	ectopic pregnancy.

81.

A delivery with a prolapsed cord means that the umbilical cord:

A.	lhas separated early from the uterine wal.

B.	is short in length and wrapped around the unborn baby's neck.

C.	presents through the vagina before the presenting part of the baby.

D.	has caused the fetus to shift positions, leading to a limb presentation.

83.

After the placenta is delivered, it should be:

A.	examined for missing tissue and then thrown away.

B.	wrapped tightly with gauze and placed in a biohazard container.

C.	wrapped in a towel, kept cool over ice, and transported to the hospital for inspection.

D.	wrapped in a towel, placed in a plastic bag, and transported to the hospital for inspection.

84.

If a pregnant patient experiences a seizure, you should:

A.	prepare for an immediate delivery.

B.	massage the uterus to relax any contractions.

C.	look for vaginal bleeding due to placenta previa.

D.	perform a rapid assessment, particularly of the airway, and transport the patient on her left side.

86.

Which of the following statements about injuries to the female genitalia is true?

A.	Foreign objects should be removed from the vagina before transport.

B.	Vaginal bleeding should be controlled by the insertion of sterile dressings.

C.	Bleeding involving the external female genitalia should be controlled with a dry, sterile dressing and direct pressure.

D.	Vaginal bleeding should be controlled by the insertion of sterile dressings.

87.

A woman loses approximately 300 to 500 mL of blood after delivering a healthy infant. You recognize that:

A.	this is a normal amount of blood loss after delivery.

B.	the vagina must be packed with sterile gauze.

C.	the mother should be placed in the shock position.

D.	the placenta must be removed immediately by manual traction.

88.

En route to the hospital with a woman who is 9 months' pregnant and in active labor, you notice that the umbilical cord is prolapsed. You should first:

A.	push the cord back into the vagina.

B.	place a dry, sterile towel around the cord.

C.	position the mother with her head down and/or hips raised.

D.	insert your sterile, gloved hand into the vagina and push the infant's head up.

89.

Care of a patient who is experiencing heavy vaginal bleeding should include:

A.	packing the vagina with pads.

B.	giving high-concentration oxygen.

C.	placing the patient in a semi-Fowler's position.

D.	holding the patient's legs together to slow the bleeding.

90.

Proper care for a premature infant should include:

A.	warming the patient compartment of the ambulance to 90° to 95°F.

B.	placing hot water bottles on the infant to keep it warm.

C.	giving oxygen with an infant-sized face mask.

D.	allowing the mother, father, and any other family members to handle the infant.

92.

When you compare a primagravida vs. a multigravida woman, a general rule of thumb is that a primagravida's length of the first stage of labor is:

A.	longer than a multigravida.

B.	shorter than a multigravida.

C.	equal to a multigravida.

D.	difficult to actually compare.

93.

Para refers to the number of:

A.	pregnancies.

B.	live births.

C.	total births.

D.	miscarriages.

94.

A 35-year-old woman, 32 weeks' gestation, reports increased swelling in her hands and feet the last week and now complains of a sudden, intense headache. Her vital signs are as follows: pulse of 92/min; respirations of 24/min; and blood pressure of 144/92 mm Hg. You are concerned she has:

A.	hypertensive syndrome.

B.	pre-eclampsia.

C.	eclampsia.

D.	vitamin B12 deficiency.

95.

A 26-year-old woman complains of vaginal bleeding, heavier than usual and a sharp pain in her RLQ. She reports her last menstrual period was 7 weeks ago and has a history of pelvic inflammatory disease. You are suspicious she has:

A.	an exacerbation of her pelvic inflammatory disease.

B.	an acute placenta abruptio.

C.	a ruptured ectopic pregnancy.

D.	pregnancy-induced hypertension.

97.

Which of the following is an indication of imminent birth?

A.	Amniotic sac ruptures.

B.	The mother states "the baby is coming".

C.	Contractions are 10 minutes apart and lasting 30 seconds.

D.	The mother instinctively begins to clean the house and pack for the hospital.

99.

Calculate an APGAR score for the following infant. Body is pink with acrocyanosis. Pulse is 88/min and respirations are absent. Infant does not cry or move when stimulated, and muscle tone is weak.

100.

You have just delivered a baby boy. His appearance is pink and his pulse is 148/min with slow respirations. He has a weak cry when stimulated and resists attempts to straighten his legs. His APGAR score would be?

10.

101.

A 17-year-old woman has delivered a small infant breech. The head remains in the birth canal. The EMT-B should immediately:

A.	contact medical control for directions.

B.	press firmly on the lower abdomen to "push" the head out.

C.	apply gentile traction to the infant's body.

D.	make a "V" with your fingers and create an airway for the infant.

102.

Mild hypothermia occurs with core body temperatures of:

90-95°F.

85-90°F.

80-85°F.

75-80°F
.

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